title: Focused force coronary venoplasty to eliminate a refractory stenosis preventing LV lead placement in two patients.
abstract: This report describes two patients who underwent a second attempt at cardiac resynchronization therapy (CRT) in the setting of a severe stenosis in the lateral coronary vein that prevented passage of a left ventricular lead. Both stenoses were unresponsive to standard noncompliant balloon dilatation but were successfully treated with the addition of a second stiff angioplasty wire beside the noncompliant balloon. Venoplasty with the addition of a side wire beside the balloon should be considered for resistant coronary vein stenosis encountered during CRT device implantation.
authors.affiliation: Advanced Implant Program, The Heart Center, and The Lancaster Heart and Stroke Foundation, Lancaster General Hospital, Lancaster, Pennsylvania, USA. seth@mcworley.com
authors.forename: Seth J
authors.initials: SJ
authors.lastname: Worley
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Gohn
authors.forename: Robert W
authors.initials: RW
authors.lastname: Pulliam
mesh_terms: D000328:Adult; D023921:Coronary Stenosis / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery*; D004567:Electrodes, Implanted; D005260:Female; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial; D019919:Prosthesis Implantation / Q000379:methods*; D016896:Treatment Outcome; D014680:Veins / Q000601:surgery*